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Reproductive health and the formation of an adequate attitude to motherhood depend significantly on the social status of a woman. An increased number of people of fertile age with burdened somatic and obstetric and gynecological pathologies, a long-term stress load caused by the social and economic crisis and military actions in the country, a high specific weight of obstetric and perinatal complications - all these factors lead to a rapid decrease in the birth rate. Pathological changes in the hormonal status of female patients, sexual health disorders, and the progressive spread of inflammatory diseases of the reproductive system lead to an increased frequency of infertility. The etiological factor is most often a microbial association, which can be represented by both absolute pathogens with a predominantly sexual transmission route, and endogenous anaerobes and aerobes. Microbial associations contribute to better adaptation of the causative agent and its parasitism, increase the pathogenicity of each causative agent, their resistance to the antibiotics, which complicates the treatment of the disease as a whole. The prevalence of papillomavirus, herpes, cytomegalovirus infection in the structure of sexually transmitted inflammatory diseases negatively affects reproductive function. The objective: to analyze the risk factors for infertility in patients with inflammatory diseases of the genital organs which are determined by urogenital mixed infection. Materials and methods. A comprehensive clinical and laboratory examination of 154 married couples with infertility was carried out. The main group included 92 women who were examined for infertility and had chronic pelvic inflammatory disease (PID) caused by urogenital mixed infection. Depending on the detected pathogens, the women of the main group were divided into groups. During the In Pouch™ test in 30 (32.6%) patients who were included in the I observation group, Trichomonas vaginalis was found in biomaterial from the vagina in association with other conditionally pathogenic factors. Chlamydia trachomatis was diagnosed in polycomponent associations with other opportunistic flora in 34 (37.0%) women using polymerase chain reaction (PCR) in scrapings from the cervical canal - the II observation group. In 28 (30.4%) examined women, the human papillomavirus (HPV) was identified in the biological material from the cervix by PCR in Real time. Women with papillomavirus infection associated with opportunistic flora were included in the III observation group. To evaluate the results of the cytological examination, the Papanicolaou classification (CIN classification) and the Bethesda terminological system (The Bethesda system, TBS, 2014) were used. Results. As a result of a complex clinical and laboratory examination of women of reproductive age from 154 married couples who were observed for infertility, 60% (92 cases) of patients were diagnosed with PID due to urogenital mixed infection. Among the specific etiological factors, Trichomonas vaginalis was found in 32.6% (30 cases), Chlamydia trachomatis in 37.0% (34 cases), and HPV in 30.4% (28 cases) in multicomponent associations with representatives of opportunistic flora. It was established that, in addition to pathogenic agents of sexually transmitted infections, representatives of opportunistic flora negatively affect the reproductive function of women, among which the leading positions are occupied by mollicutes (Mycoplasma hominis, Ureaplasma urealyticum) - 67.4%; Enterococcus faecalis – 44.6%; Esherichia coli – 38.0%; Gardnerella vaginalis – 26.0%, with a maximum decrease in the vaginal content of the number or even absence of Lactobacillus spp. In the majority of women - 78.0% (64 cases), the inflammatory process had no pronounced clinical signs, in 22.0% it was almost asymptomatic, but was accompanied by frequent (up to 3-6 per year) relapses. Among the examined women of the III group, an association of two highly oncogenic HPV genotypes was found - 11 (39.5%) cases, three or more - 7 (25.0%) cases. A tendency to an earlier onset of sexual life was determined in women with sexually transmitted diseases, especially in the group with papillomavirus infection. Risk factors for infertility include the pathological course of childbirth and the postpartum period, surgical interventions, and infectious diseases. Among the diseases of the hepatic and biliary system, chronic cholecystitis prevailed. Conclusions. On the basis of the anamnestic assessment of reproductive health in the examined women with infertility on the background of chronic PID, it is possible to single out the most important factors that negatively affect the realization of the reproductive function: the age of a woman is less than 20 and more than 30 years, social maladaptation, working conditions and harmful habits, in particular smoking, as one of the cofactors of HPV-associated diseases of the cervix, as well as early sexual debut (up to 16 years), promiscuity, ignoring barrier contraception. In the genesis of pathological changes occurring in the urogenital tract, there are mixed infections, which potentially complicates diagnosis and negatively affects the results of treatment of associated forms of diseases. [ABSTRACT FROM AUTHOR]

Urinary tract infections (UTIs) are a significant public health problem. Every year the situation becomes more complicated due to the high rate of recurrence and the growth of resistance among the population. Research results show that about 150 million people suffer from bacterial infections of the urinary tract every year, and about 6 million visits to the doctor about UTIs are registered in the US every year, of which more than 2 million are related to cystitis. In Ukraine, UTIs rank first among all urological diseases, more than 170,000 cystitis patients are registered annually for the first time. 20% of girls till 20 years old have at least one episode of acute cystitis, and 25–40% of women experience a recurrent episode within a year after an episode of acute cystitis. Treatment of cystitis depends on the influence of many factors, which include: age, gender, state of the immune system, recurrences, urological pathologies, severity of the disease and the risk of developing multiple drug resistance. For the prevention of the antibiotic resistance development, it is recommended to use combined herbal preparations for long-term prevention of episodes of recurrent cystitis. The objective: to evaluate the effectiveness of the use of the proposed herbal preparation in the complex treatment and prevention of recurrence in patients with acute uncomplicated cystitis and the chronometry of the onset of action of the drug in monotherapy. Materials and methods. The study was included the patients with acute uncomplicated cystitis. The main group involved 40 persons who were prescribed antibacterial therapy in the form of a single use of fosfomycin trometamol 3 g per os or sulfamethoxazole/trimethoprim 400 mg/80 mg 2 tablets twice a day for 5 days in combination with a herbal preparation (a combination of medicinal plant components of centaury herb, lovage root and rosemary leaves) 1 tablet 3 times a day for 3 months. Patients of the comparison group (40 subjects) received only antibacterial therapy. Treatment effectiveness and side effects were evaluated 10 days after its initiation. Determination of the presence and frequency of recurrence of the disease was carried out 3 and 6 months after its onset. At the second stage of the study, the effectiveness of the use of the herbal preparation was evaluated as a prevention of recurrence of cystitis and relief of its first signs. At the appearance of the first signs of recurrence of the disease within 6 months after the end of the primary course, patients of both groups were recommended to immediately start using the herbal preparation, 1 tablet three times a day. To determine the speed of the onset of the pharmaceutical action of the drug, each patient was asked to fill out a questionnaire regarding the chronometry of the reduction or disappearance of symptoms. Results. After completion of treatment, a positive effect was observed in 38 (95.0%) patients of the main group and 37 (92.5%) of the comparison group, leukocyturia stopped in 39 (97.5%) and 38 (95.0%) patients, respectively, dysuria – in 37 (92.5%) and 38 (95.0%), respectively. The effect of the proposed herbal preparation was maximally manifested in reducing the rate of recurrence of cystitis, which has important clinical significance. It is quite clear that for the occurrence of a sporadic episode of acute cystitis, timely and effective antibiotic therapy is selfsufficient and accordingly hides the effect of phytotherapy. Use of the proposed herbal preparation for 3 months provides long-term rehabilitation of the lower urinary tract due to the aquaretic and antimicrobial effect of the herbal preparation and prevents the recurrence of the disease. Conclusions. The use of the proposed herbal preparation as part of combined therapy in patients with acute uncomplicated cystitis demonstrated its effectiveness in 95.0% of patients. The appointment of the proposed drug of plant origin prevents the occurrence of recurrence in 97.5% of patients, which allows us to recommend it for use in order to prevent relapses of the disease. The use of the proposed preparation of herbal origin helps to reduce the feeling of incomplete emptying of the bladder, starting from 62.9±17.0 min and the disappearance of pollakiuria – by 179.7±23.0 min, which allows to make quick assess of phytotherapy effectiveness and, if necessary to strengthen it in time. [ABSTRACT FROM AUTHOR]

Urinary stone disease (USD) is the most common and progressive disease of the urinary system, which is characterized by frequent exacerbations and a severe course. This is a complex disease caused by various causes, in which several biochemical processes are involved, occurring not only in the urinary system, but also in the whole organism. USD depends on geographical, climatic, ethnic, dietary and genetic factors. Over the past 20 years there has been an increase prevalence of this disease. The course of USD is characterized by the acute and chronic pyelonephritis and frequent recurrence, which leads to the development of renal failure, disability and fatal consequences. Calculus can form de novo anywhere in the urinary tract. The pathophysiology of USD differs depending on the place of stone formation and depends on endogenous and exogenous factors. Urinary tract stones are classified depending on etiology, location, size, number, frequency of occurrence, and radiopacity. The main symptoms of USD are pain of various nature; microscopic hematuria; dysuria, which most often indicates the presence of a stone in the urinary bladder or a low location in the ureters; discharge of crystals of urinary salts or concretions; increased body temperature. The diagnosis of USD is based on a carefully history taking and physical examination, which allows to determine the correct direction of diagnostic approach, which include laboratory and instrumental methods of diagnosis. Ultrasound diagnosis is used as the main method for visualization of calculi, but recently non-contrast-enhanced computed tomography has become the standard for the diagnosis of acute low back pain, replacing intravenous urography. The choice of treatment is based on many parameters, such as the number, size, morphology, shape, volume, mobility, hardness and location of the stones and is individualized for each patient. There are two main approaches: conservative treatment and surgic al one. Medicinal treatment of USD is used primarily to prevent the repeated formation of new stones or to increase those inclusions that are already present in the organs. Drug therapy is carried out with the aim of normalizing processes in the body, the failure of which leads to the development of pathology. However, conservative treatment has its limitations and is most often used as a symptomatic treatment. Open laparoscopic interventions are rarely used recently, minimally invasive methods are more popular: extracorporeal shock-wave lithotripsy; ureterorenoscopy; percutaneous nephrolithotomy. Taking into account the increase in the prevalence of USD in Ukraine and disability (the third place among the general spectrum of causes of disability in urological practice), the article analyzes and reviews modern approaches to classification, early and accurate diagnosis, and choosing a timely and correct method of treatment. [ABSTRACT FROM AUTHOR]

The objective: to analyze the effectiveness and tolerability of a dietary supplement, which includes: Saw Palmetto (Serenoa repens), pumpkin seeds (Cucurbita moschata), African tuber (Hypoxis hemerocallidea), stinging nettle root (Urtica dioica), African plum bark (Prunus africana), rye pollen extract (Secale cereale), in the treatment of patients with benign prostatic hyperplasia (BPH) and chronic prostatitis (CP) for 6 months. Materials and methods. 60 men were examined, they were divided into two groups: the main group (MG) - 28 patients who received the dietary supplement for 6 months, and the comparison group (CG) - 32 patients who used another combined herbal preparation for the treatment of BPH and CP. MG and CG patients were similar in terms of age, disease duration, and urination rate. Patients of both groups were examined using clinical, laboratory and instrumental methods before the start of treatment and after its completion in 6 months. Results. The main result of the research can be considered that the use of a dietary supplement based on Saw Palmetto (Serenoa repens), pumpkin seeds (Cucurbita moschata), African tuber (Hypoxis hemerocallidea), stinging nettle root (Urtica dioica), African plum bark (Prunus africana), extract of rye pollen (Secale cereale) gives an excellent long-term effect in 96.4% of patients with CP and BPH. As a result of the study, this dietary supplement demonstrated its effectiveness in the treatment of patients with BPH and CP for both subjective (IPSS and QOL, pain sensation) and objective indicators over a period of 6 months. During therapy the volume of residual urine in patients probably decreased and the maximum urinary flow rate increased. Conclusions. Dietary supplement, which includes Saw Palmetto (Serenoa repens), pumpkin seeds (Cucurbita moschata), African tuber (Hypoxis hemerocallidea), nettle root (Urtica dioica), African plum bark (Prunus africana), rye pollen extract (Secale cereale), is well tolerated by patients, has high therapeutic efficiency, does not cause side effects, does not disturb the sexual function of patients with BPH and CP, which allows to prescribe it for a long time. [ABSTRACT FROM AUTHOR]

Benign prostatic hyperplasia (BPH) is one of the most common benign diseases in men, as it leads to an enlarged prostate, the development of lower urinary tract symptoms, and worsens the quality of patient’s life. Surgical treatment is indicated to patients after non-effective drug treatment. Most often, transurethral resection of the prostate (TURP) is used. The objective: to improve the results of TURP in patients with BPH and acute urinary retention by optimizing antibacterial prophylaxis of postoperative complications in the early postoperative period. Materials and methods. An analysis of the surgical treatment of 179 patients with BPH with acute urinary retention after TURP was performed. The age of the patients varied from 51 to 84 years old, the average age was 64.9±5.1 years. All patients had a complex urological examination in the preoperative period. The patients were divided into two groups: I group – 85 patients after operation who were prescribed ceftriaxone in the early postoperative period; II group – 94 patients who received levofloxacin in the early postoperative period. Results. It was determined that complications occurred in 43 (24.1%) patients in the early postoperative period. Long-term macrohematuria was found in 23 (12.9%) patients, exacerbation of chronic pyelonephritis was in 13 (7.3%) patients after operation, acute urethritis developed in 7 (3.9%) patients, acute orchiepididymitis – in 9 (5, 0%) patients. It has been proven that the total frequency of complications in patients with BPH who received levofloxacin in the early postoperative period was statistically significantly lower than in the patients who were prescribed ceftriaxone. Conclusions. The use of levofloxacin for the prevention of early postoperative complications after TURP in patients with BPH complicated by acute urinary retention improves the results of surgical treatment by reducing the frequency of postoperative complications by 60%. [ABSTRACT FROM AUTHOR]